Long term curative effects of composite graft on children’s cutaneous deficiency wounds caused by road accident

Abstract:

Objective：To investigate long term curative effects of composite graft of acellular allogenic dermal matrix and razor thin autoskin on children’s cutaneous deficiency wounds caused by road accident. Methods：Totally 60 children with cutaneous deficiency wounds caused by road accident were enrolled and were divided into two groups randomly and equally. In treatment group（n=30）：cutaneous deficiency wounds were debrided and grafted with acellular allogenic dermal matrix；after 3 weeks，wounds were grafted with razor thin autoskin. In control group（n=30）：cutaneous deficiency wounds were debrided and grafted with razor thin autoskin. The wounds were followed-up for 1 month，3 months，6 months，1year and every year until the 5th year after the operation to investigate their appearance ，color and elasticity. Dermis thickness and hardness were measured respectively by SEQULA512 color ultrasono－graph and hardness machine. Results：Follow-up at earlier stage：compared with that in control group，appearance of the operated area in treatment group was well-stacked with lighter scar and no scar breakage and bubble. Five-year follow-up：color of the operated area in treatment group was similar to that of normal skin. Appearance of the operated area in treatment group was well-stacked，smooth and soft with light scar and good elasticity. According to the results of ultrasonograph，thickness of dermis was lower in treat－ment group than in control group（P=0.000），lower in normal skin group than in treatment group（P=0.000）. Dermal echo and hardness in treatment group were close to those of normal skin. Appearance of the operated area in control group was serious sagged with heavy and hard scar and poor elasticity. Thickness and hardness of dermis were both exceeded those in treatment and normal skin groups（P=0.000）. Ultrasonograph showed dermal echo in control group was obvious mixed and disorderly enhanced. Conclusions：Long term curative effect of composite graft of acellular allogenic dermal matrix and razor thin autoskin on children’s cutaneous deficiency wounds is better than that of only razor thin autoskin graft，which can improve healing quality of skin and has fine clinical value.